GRAND CANYON

U N I V E R 5 I T YN

Clinical Evaluation Tool

NSG-320C

SemesterNear: 5vrincj 7.,\)\~ le\)(:;\ 2

Evaluation Day and Date: 2/2sho..

Student First Name Last Name: k'.o.m r\ t lJOd.li<e&
Clinical Faculty First Name Last Name: jfS~ ·1CCl-~Ct }'.)Cl
. Course Ob.iectives
1. Create a nursing plan of care that prioritizes safe, evidence-based, holistic client-centered care for the adult client in a variety of
settings.
2. Interpret assessment, lab, and diagnostic data to detect changes in condition and plan and prioritize appropriate care of the
adult client.
3. Delegate care to interdisciplinary team members based on knowledge of their role and scope of practice.
4. Implement a collaborative client-centered transitional plan of care that includes medication education, self-care strategies
and follow-up care for the adult client.
5. Demonstrate the use of effective communication strategies with clients, family and interdisciplinary team members.
6. Demonstrate increasing proficiency in the performance of psychomotor nursing skills with the adult client.
7. Demonstrate appropriate safety protocols and standards of care while working in the client-care setting.
8. Exhibit professional nursing behaviors based upon the standards and scope of nursing practice.

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 - Midterm Final

NSG-320C Clinical Competencies ..

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Assll!JI a score of 1 to 3 for each
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competency In the boxes below.

Client-Centered Care See the Cllnkal Scorlni
G uidelines below for additional
deta.lL
Develop an individualized plan of care with a focus on assessment and planning, utilizing the
nursing process while respecting the diversity of clients. ~ J 3 3
Demonstrate caring behaviors, including assessing for the presence and extent of pain and
suffering.* 7_ l 3 3
Interpret assessment, lab, and diagnostic data to detect changes in condition and prioritization of
interventions in the care of the adult client. ~ :1 '2 ~
Develop a collaborative, client-centered transitional plan of care that includes medication
'Z. {)._ 2. ;;)
education, self-care strategies, and follow-up care for the adult client.
Demonstrate increasing proficiency in the performance of psychomotor nursing skills with the
adult client. L. ~ ~ J..
Safety, Informatics, and Quality Improvement
Demonstrate standardized infection control practices (hand washing and PPE) that support
safety and quality, and implement strategies to reduce risk of harm to self or others.* 2 3 3
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Identify two client identifiers, six rights for medication administration, and verification of care
orders for the client prior to implementation as encountered in the clinical environment.* 2 ~ 3 3
Demonstrate appropriate safety protocols and standards of care while working in the client-care
setting. 2 1 3 3
Document clear and concise responses to care, as appropriate for clinical setting (i.e., EHR,
paper documentation, care plan). 7- ~ ~ 3

2
Protect confidentiality of all client data and promote the ethical use of electronic health
information.* z 3 3 3
Identify methods to deliver care in a timely and cost-effective manner.
L. I), 3 J.
Teamwork and Collaboration
Develop effective verbal and written communication skills with clients, team members, and
family. 2. ~ 3 ~
Identify relevant data for communication in preconferences and postconferences. 2 l 3 3
Identify intraprofessional and interprofessional team member roles and scopes of practice, and
establish collaborative relationships with team members. z J 2- ~
Delegate care to interdisciplinary team members based on knowledge of their role and scope of
practice. z ~ z :).

Identify the need for help when appropriate to situation. & i 3 :2.
Professional Role
Demonstrate core professional values (such as caring, altruism, autonomy, integrity, human
dignity, and social justice) while complying with the ANA Code of Ethics and Standards of
Practice, and policies and procedures of Grand Canyon University, College of Nursing and z J- 3 3
Health Care Professions and clinical agencies.*
Maintain a positive attitude and interact with interprofessional team members, faculty, and
fellow students in a positive, professional manner, including accepting constructive feedback
and developing a plan of action for improvement.*
z ;}- 3 3
Arrive punctually, demonstrate expected behaviors, complete tasks in a timely manner, and
maintain professional behavior and appearance."' 'Z J 3 3
Accept individual responsibility and accountability for nursing interventions, outcomes, and 3
other actions: engage in self-evaluation; and assume responsibility for learning."' --z.. i )
Critical competencies are highlighted in yellow. Students who score a 1 (Does Not Meet) on any of these competencies atfinal evaluation willfail the clinical
course. Target performance is a Score of3 (Independent) on the competencies marked with an asterisk* by final evaluation.
Content of this checklist is based on Quality and Safety Education for Nurses (QSEN) competencies and knowledge, skills, and attitudes (KSAs):
Quality and Safety Education for Nurses Institute. (2017). QSEN competencies. Retrieved from http://qscn.org/compctcncics/prc-liccnsurc-ks.1s/
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r Midterm Evaluation Comments

Student Comments (Identify three areas for development):

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Final Evaluation Comments

Faculty Comments (Include strengths . and

. areas for improvement): .
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Student and Clinical Faculty Signatures

Signatures indicate student and clinical faculty have reviewed and discussed the Clinical Evaluation Tool.

Student Signature at Midterm: ~ D~ Date: 7- /7..5 / \~

Student Signature at Final :_--+~---=

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L _- _-_- - - - - - - - - - - - -- - -- -D.ate : 'Y / 8/ I 5

Clinical Faculty Signature at M idterm.~~~~~~~'::d..~::::::::::::_-1--!_!__/__;_~_ _ _ __ _ _ _ __ ___D ate: a,a~;)DJ9

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Clinical Faculty Signature at Final : Q w1 1/ ~
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